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Heme Doc

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Posts posted by Heme Doc

  1. 4 minutes ago, smoky said:

    Should otherwise healthy kids be vaccinated?

    This is a great question that’s complex and which we have zero data.

    We know COVID is less serious for kids than seasonal flu.  The main argument to vaccinating kids would be to help end the pandemic quicker so kids aren’t spreading it to adults/others who are more likely to have severe disease.  But those higher risk adults will have already been vaccinated by the time kids are up for vaccinations.   

  2. 8 hours ago, Horn Dog said:

    In life, unfairly vilified and misunderstood.  No creature of god’s creation deserves this kind of vitriol!  Cursed by the extremists on both sides, yet never stopped growing and maturing even though time on this earth was too short.  Even despite the curses, insults and hate filled poison coursing in the blood stream.  Not the hero we wanted, but the hero we needed.   Rest in peace cancer.... with our deepest appreciation.

    Legit lol.  Well done.  As a cancer doctor, my sense of humor is darker than just about anyone.  

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  3. 7 hours ago, Pablo said:

    I never had obvious symptoms loss of taste or smell.  I had one episode of high fever and body aches around Thanksgiving last year, but it was only one day.  I also had a crazy chest cold back in January of 2020.  Never got tested, but never thought I needed to.  
     

    I am wondering if I could learn anything after 10 days from an antibody test?

    If you had really high titers of antibodies to Spike already, that would be consistent with you already having COVID (prob around Thanksgiving) and you wouldn’t need the 2nd dose

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  4. 5 hours ago, Pablo said:

    The side effects from my 1st Pfizer shot were really scary.  Day 1 there were no issues, but midday on Sunday, I started getting serious chills and then fever, body aches and a headache.  On top of that, my heart rate was racing.  I kept using my heart rate monitor and would get more anxiety just watching it skyrocket.   I never had an appetite and only ate for the first time today about an hour ago.  This morning I finally feel somewhat back to normal.

    This is making me hesitate on the 2nd shot, because I hear that the side effects are worse on that one.

    Have you already had COVID?

  5. Lots of confusion/concern out there about the AZ vaccine effectiveness against South African variant.  So I’ll try to help explain...

    The AZ trial in question looked at healthy adults age 18-65 in South Africa.  AZ vaccine is super cheap ($3/dose) so it’s the one a lot of poor countries are betting on.  They designed the trial to show 60% effectiveness against getting symptomatic COVID.  They only enrolled 1789 participants and only had 42 cases of COVID in the trial (19 in vaccine and 23 in placebo).  So it was quite under powered to show what they wanted it to.  Of those 42 cases, all were mild.  Nobody needed the hospital or oxygen.  But that’s what you might expect in a younger healthier study population.  

    So this was a small study but protection against SEVERE disease with AZ is unknown but probable.  J&J vaccine shows excellent protection (89%) against severe disease due to the SA variant.  

    Thanks for reading.  

    I will bill the surly fund for $1,000.  


     

     

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  6. 1 hour ago, Red Five said:

    How big of a deal is it that Astrazeneca doesn't protect against the South African variant?

    I think a correct answer would be “we don’t know yet, but probably not that big a deal”

    The AZ study in South Africa showed no difference between placebo and vaccine in protecting against mild or moderate infections.  So, I’m sure your next question is how it did against things we REALLY care about like severe infections, hospitalizations, and death.  But the problem is the study wasn’t looking at that. They only enrolled younger people and didn’t have any hospitalizations or death.  
     

  7. 2 hours ago, Bevo said:

    You laugh, but it is so stupid that I have to consider this. I am over there for 4 days. If they are too slow getting the results back or I get a false positive, I am screwed. And at some point, it needs to stop. Does evidence show that there is a greater chance of getting COVID after vaccination with Moderna than there is from a person who has recovered from COVID? Eventually, the authorities need to trust the vaccine, otherwise we will never get over the pandemic. I can't imagine having to wear a mask in public for the rest of my life.

    Agree that it’s totally stupid.  As a vaccinated person who had to cancel international travel because of this, you’re absolutely preaching to the choir here.  

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  8. 1 hour ago, midtown said:

    If he's willing to have a coworker falsify that he had covid and present that false document to the US Government and commit fraud why not falsify a positive test.    My last test result looked like it was done by a fifth grader

    You want a positive test?  I can get ya a positive test dude.  Believe me there are ways dude.  I can get ya a positive test result by 3 o’clock this afternoon.  With nail polish.
     

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  9. 7 hours ago, Bevo said:

    I am traveling out of the country in a few weeks for a short trip and have been vaccinated. The state department says that for re-entry a negative COVID test is necessary regardless of vaccination status. In lieu of a negative COVID test, documentation of recovery from COVID will suffice. It is a very short trip and I don't think I can take a COVID test there and get results back quick enough for my return flight. So, it sounds like my only choice is to have a colleague state that I have recovered from COVID. It seems stupid so I wonder if I am interpreting things correctly.

    You are interpreting things correctly.

    And I don’t think you can just have a doc state that you’ve recovered from COVID.  You need to provide a positive COVID test result within 90 days of travel.  

  10. My read on the various vaccine data and trials is that all these vaccines kick serious ass.  Do some kick a little more ass than others?  Perhaps.  But you’re probably splitting hairs and they’re all much more similar than different.  

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  11. 2 hours ago, Brisketexan said:

    Thanks.

    As I understand (or maybe that's a hopeful understanding).  It's 95% in preventing symptomatic disease, and even higher than that for preventing severe disease (hospitalization/death)....correct?

    And as for the presence of antibodies, is our understanding that there are other infection-fighting goodies that are generated that may not be measured by the antibody tests?

    That’s all correct

    Based on 2 large trials, mRNA vaccines are both:

    95% effective at keeping you from getting symptomatic COVID and pretty much 100% effective at keeping you from getting severe COVID, being hospitalized, or dying

    The antibody test situation is evolving and I believe LabCorp is offering antibody tests and titers against Spike.  Plus vaccines do induce other vaccine fighting goodies like T cells which help protect you but are much harder to measure

     

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  12. https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1.full.pdf
     

    Here’s some solid data in pre-print form from a very reputable lab.  It shows what we suspected.  
     

    1.  If you already had COVID, you’re more likely to react to first dose of mRNA vaccine

    2.  If you already had COVID, you probably just need one vaccine dose to achieve the same level of immunity as those who never had COVID that received 2 doses

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  13. On 1/26/2021 at 7:32 AM, BradInATX said:

    My money is on the vaccine preventing spread like every other vaccine in history. The media is acting irresponsibly here. They hear a scientist say "right now we don't have enough data to decisively conclude that the vaccine prevents spread", and the headline is "Covid vaccine doesn't prevent spread zomg". Dumb.

     

    THIS!

  14. 43 minutes ago, Liquor and Poker said:

    Here's another question - one of my elders has had a hell of a time with the vaccine.  48 hours in we've had blurred vision, feeling like in a sauna, pretty bad nausea, severe pain at shot site.  Nothing like fever or rash or other cause for alarm, but much worse than the other 4 elders by far.  What's interesting is that he is the one we were somewhat sure had actually already had COVID but never got a test while he felt sick.  COVID (if that's what it was) was much milder than this vaccine so far.  

    So now I'm wondering if (i) it's more intense for people who already had COVID (which honestly only makes sense in a "this shit is weird" way) or (ii) we were wrong, he didn't have it, and that there's a possible correlation between reaction to the vaccine and how sick he would have been had he actually really had COVID (which kinda makes sense logically).

    Any data there?

    Anecdotally, people who’ve had COVID seem to react more strongly to the vaccine.  Likely due to the immune system already being primed against the virus and when the immune system sees virus again, it’s super pissed off about it

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  15. 23 minutes ago, DaysOff said:

    The Pfizer study tech told my wife we'll be wearing masks into 2022. Lolz, there's no way Karen and Ken will tolerate that past this summer.

    Lol.  Yeah.  I’m sure the Pfizer study tech knows all about it.  
     

    I’m vaccinated.  I’m ok wearing a mask until a critical mass is reached and once we have good data showing that vaccines do in fact prevent infection (likely), and not just asymptomatic infection.  I’d also like to see cases and hospitalizations go WAY down.  
     

    But once all those things occur, which I suspect will be May/June ish, there is no fucking point in wearing a mask past that.  None.  Back to normal.  If you want to wear a mask because it makes you feel safer...go for it.  If you want to wear a mask if you’re feeling a little sick...that’s probably a great thing to do.  

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  16. 23 hours ago, rage-a-holic said:

    As a physician that was vaccinated in August with the Pfizer vaccine on trial, I’m fucking PISSED about this.  Having to cancel several international trips for 2021

  17. 12 hours ago, Anastasis said:

    I've been hearing second hand anecdotal reports from ED nurses that had covid.  When they were vaccinated apparently some fairly significant reactivity, 3-4 days of flu like symptoms after first dose.  Anyone seeing/hearing similar?  

    Yes.  Similar.  Reactions seem to be more pronounced if you’ve already had COVID

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  18. 48 minutes ago, Anastasis said:

    Yeah, that is my position as well. I think it likely that the vax sterilizes and prevents/reduces transmission, but there is no definitive data. 

    I agree.  Vaccines likely prevent infection (not just symptoms), although not much data on this yet.  There’s good data that this is the case with immunity from natural infection (prevents infection - not just symptomatic infection), and hopefully we will have data from the vaccines soon.  So if you can’t get it, you can’t spread it.  

    Interestingly, my mom in her 70s got COVID about 3 weeks ago.  Fortunately, she had a mild case, but my dad (in his 70s) tested negative and never got symptoms.  My dad was in the Pfizer trial and found out today that he got vaccine and not placebo.  So, I guess the vaccine may have prevented him from getting it from my mom.  

  19. https://www.nejm.org/doi/full/10.1056/NEJMoa2034545?query=featured_home
     

    Not sure where else to post this so I’m putting it here since I think it has important implications for vaccine efficacy.

    Here’s the short version of this study out yesterday in the NEJM...

    The folks at Oxford teaching hospitals in England checked about 12,000 hospital staff for antibodies to COVID starting in March.  They found about 1200 people who had COVID antibodies, and the rest (about 11,000) didn’t.  Then, they did PCR nose swabs if anyone had symptoms of COVID AND every 2 weeks on everybody (even asymptomatic).  They did this for about 8 months.  

    So of those 11,000 people who didn’t have antibodies, 223 tested positive for COVID during the 6-8 months of follow up.  (100 were asymptomatic and 123 had symptoms)

    And those 1200 who had antibodies...2 documented PCR positive tests.  Both asymptomatic.

    So this is strong evidence, in my eyes, that antibodies to COVID (whether through prior infection in this study or vaccination) are protective against getting COVID at all and not just SYMPTOMATIC COVID.  

    So, if you are immune, you hopefully don’t need to worry as much about potentially having an asymptomatic COVID infection and then spread it to a non-immune person

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